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OCDSB 516 Student Action Plan (Elementary)Appendix D to PR 515 SCO OCDSB 517 School Operations (2019) OCDSB 516 STUDENT ACTION PLAN (ELEMENTARY GRADES 7, 8) (References: P.026.SCO and PR.515.SCO) Once completed, this form becomes confidential. A copy of this document is also placed in the OSR for the same time period established for all other related suspension documentation. A. Student Information Full Name DOB OEN B. Parents/Guardians Information Parent/Guardian 1 Parent/Guardian 2 Name Address Phone number Email C. Activity Details The student is suspended ( ) expelled ( ) Reason for suspension/expulsion Date of suspension/expulsion D. Learner Profile Please Provide the Following if Applicable [ ] Most recent Report Card/Progress Report [ ] Individual Education Plan (IEP) [ ] Individual STEP Assessment [ ] Safety Plan [ ] Other OCDSB 516 School Operations (2019) E. Academic Component Please identify the course/work assignments that the student should work on during their time in the program. F. Non – Academic Profile To be completed in consultation with District multi-disciplinary team staff for students suspended eleven (11) or more days or who are expelled. Please note that for students expelled from all the schools of the District, the satisfactory completion of the non -academic component will be used to determine when the expulsion will end and the student may return to a regular program. Goal Support/Resources Available Success Indicator (s) Other professionals Involved in supporting the non -academic component: Name Role Contact G. Planning Meeting Name Chair Participants OCDSB 516 School Operations (2019) Primary School Contact Signature of Principal Date Signature of Parent/Guardian Date The personal information on this form is collected under the authority of the Education Act (RSO.1990 c.E.2) ss. 58.5, 265 and 266 as amended, and in accordance with the Municipal Freedom of Information and Protection of Privacy Act (RSO.1990 c.M56), as amended. It will be used for student and education related purposes, such as administration, communication, and data reporting. In addition the information may be used or disclosed to comply with legislation, for compelling circumstances affecting health and safety or discipline, as required in circumstances related to law enforcement matters, and with third parties in accordance with establishes service agreements or in accordance with any other Act. Questions or concerns should be directed to the school principal or the District's Freedom of Information Coordinator, Ottawa-Carleton District School Board, 133 Greenbank Road, Ottawa, Ontario K2H 6L3, Telephone 613-596-8211, ext. 8607.